- Enrollment id
- O20190624002361
- Enrollment state
- OK
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1689234627
- Multiple npi flag
- N
- Ccn
- 375117
- Associate id
- 9830423946
- Organization name
- OAK HILLS CARE CENTER RECEIVERSHIP, LLC
- Doing business as name
- OAK HILLS LIVING CENTER
- Incorporation date
- 2019-03-25
- Incorporation state
- OK
- Organization type structure
- LLC
- Proprietary nonprofit
- N
- Nursing home provider name
- OAK HILLS LIVING CENTER
- Address line 1
- 1100 WEST GEORGIA
- City
- JONES
- State
- OK
- Zip code
- 730497556